There have been some case reports of phantoms which persisted for 44 (Livingston, 1945) and 57 years (Abbatucci, 1894). Some patients require a certain stimulus or stimuli to "activate" their phantom limb. Sacks (1985) revealed a case of one patient who describes how he has to wake up his phantom limb in the morning. In order to do this he has to first flex the thigh-stump towards him and then he slaps it sharply many times. On the fifth or sixth slap the phantom would shoot forward and suddenly be felt by the patient. It seems the peripheral stimulus is essential to support the sensation. Only then he can put on his prosthesis and walk. It seems that "waking-up" the phantom limb is essential for some patients to feel them. Other cases have shown that looking at where the phantom limb should be, causes the sensation to disappear. This disappearance and reappearance can become frustrating for patients as their perception of touch is, in a way, morphed.
Some cases of phantoms have had serious psychological effects on the patients. The impact of the pain associated with phantom limbs compounds the emotional toll which occurs as a result of a once functional body part. This phantom pain has been linked to disabled psychosocial dysfunction, sleep disorders and significant decreases in quality of life, (Csicseri, 2012). Furthermore, they also contribute to long-term adverse health outcomes due to inactivity and nerve dysfunction. Cardiovascular disease, obesity, and chronic joint and low-back pain are serious illnesses which can be caused by an amputated limb and lack of prostheses.
Ramachandran & William Hirstein (1998) found that almost immediately after the loss of a limb between 90 and 98% of patients will experience the sensation of a phantom limb. However phantoms are seen far less often in early childhood. This could be simply because there may not have been enough time for the body image of young children to develop.